ABSTRACT Support is requested for a Keystone Symposia conference entitled Unraveling the Secrets of Kidney Disease, organized by Drs. Katalin Susztak, Caroline Fox and Masaomi Nangaku. The conference will be held in Whistler, British Columbia from March 3 - March 7, 2019. Approximately one in eleven people in the world suffers from kidney disease. The incidence of kidney disease is increasing especially in the developing world. This issue was recently reviewed and emphasized in a Lancet article (Global Health Atlas). Acute and chronic kidney disease is associated with a highly significant increase in cardiovascular death. Chronic kidney disease (CKD) represents a leading cause of death in the United States. There is no cure for this disease, with current treatment strategies relying on blood pressure control through blockade of the renin-angiotensin system. Such approaches only delay the development of end-stage kidney disease and can be associated with serious side effects. Recent identification of several novel mechanisms contributing to CKD development - including vascular changes, loss of podocytes and renal epithelial cells, matrix deposition, inflammation and metabolic dysregulation - has revealed new potential therapeutic approaches for CKD. This conference will review clinical and observational studies in the kidney disease area, highlight recent advances in basic biology of kidney and kidney disease, assesses emerging strategies and agents for CKD treatment, and discuss major obstacles in drug development. This conference will also encourage collaborations among clinicians and researchers from academic institutes and pharmaceutical laboratories and accelerate innovation in this field. There has not been a conference in the area in kidney disease that would bring together clinicians, basic scientists and industry and foster collaboration. Small focus conferences have been organized by the International Society of Nephrology, but these conferences are limited to a single special topic. Furthermore, more than half of kidney disease is caused by diabetes; this conference will be paired with a conference focused on diabetes, thus affording the opportunity to understand the role of diabetes in the development of kidney complications.